Prototype Matching Predicts Psychopathology Better Than DSM-IV

Prototype Matching Predicts Psychopathology Better Than DSM-IV

Prototype matching -- comparing a patient's clinical presentation with a prototypical description of the disorder – may be a viable alternative for psychiatric diagnosis of mood and anxiety disorders. This report of two studies found clinicians' prototype diagnoses outperformed DSM-IV decision rules in predicting psychopathology and global functioning.

With DSM an object of unrelenting criticism, and with the about-to-be-released DSM-V unlikely to satisfy the critics, these authors discuss several solutions, including revising DSM criteria, radically reformulating them, using biomarkers to define new categories, and creating new categories based on brain circuits or functions. They contend that mental disorders can only be fully understood when, as in the rest of medicine, pathology is understood in terms of normal functions and mechanisms.